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1.
BMJ Case Rep ; 14(6)2021 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-34116987

RESUMO

Melkersson-Rosenthal syndrome (MRS) is a rare neurocutaneous syndrome characterised by the triad of recurrent orofacial swelling, facial nerve palsy and fissured tongue. This diagnosis is particularly rare in children. We aim to increase awareness of the syndromic association of these clinical features since most patients present with a monosymptomatic form, reiterating the importance of detailed history and thorough physical examination, for the timely identification of these patients. Not only the recurring of symptoms, but also the association of MRS with other medical conditions, make 'earlier' diagnosis of the Syndrome beneficial. The average delay in diagnosis is 4-9 years. Although most cases resolve without treatment, when treated,steroids are most commonly used. Variable options have been tried for refractory and frequently recurrent cases. We present a case of MRS in a 12-year-old girl, diagnosed 3 years after onset of symptoms. We reviewed updated literature for MRS and associated clinical conditions as well as published treatment options.


Assuntos
Paralisia Facial , Síndrome de Melkersson-Rosenthal , Síndromes Neurocutâneas , Língua Fissurada , Criança , Feminino , Humanos , Síndrome de Melkersson-Rosenthal/complicações , Síndrome de Melkersson-Rosenthal/diagnóstico , Síndrome de Melkersson-Rosenthal/tratamento farmacológico , Recidiva
2.
BMC Infect Dis ; 21(1): 521, 2021 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-34078297

RESUMO

BACKGROUND: The clinical manifestations of recent syphilis can be variable, with typical and atypical patterns. Several conditions may cause atypical clinical aspects, including human immunodeficiency virus (HIV) co-infection. Besides the clinical features, co-infections may completely alter syphilis serological tests, causing interpretative difficulties and diagnostic delays. Aim of the work is to describe the difficulties encountered during the diagnostic evaluation of atypical skin manifestations and of the serology for syphilis of an HIV-infected patient who had contracted it several times. CASE PRESENTATION: In 2020, a 52-year old HIV-positive bisexual male patient was admitted to our department with a 4-month history of moderately itchy cutaneous lesions localized at his neck, trunk and arms. In 2013, the patient presented with a classic syphilitic roseola of the trunk and a secondary syphilis was diagnosed, with increased levels of rapid plasma reagin (RPR), Treponema pallidum hemagglutination assay (TPHA), anti-Treponema pallidum IgM and IgG Index. A second episode occurred in 2018, as a primary syphilis with multiple ulcerative lesions of the penis, and increased levels of RPR, IgG and IgM. In 2019, a further episode of secondary syphilis was treated with Doxycycline. In 2020, erythematous and papular lesions with vesicular components and urticarial erythema multiforme (EM)-like lesions were present at the neck, trunk and arms. Serological tests and Nucleic Acid Amplification Test (NAAT) for Treponema Pallidum were performed, as well as a cutaneous biopsy with histological and immunohistochemical evaluation of one lesion. NAAT was negative for T. pallidum. Serological test results were discordant with a new syphilis infection, showing only increased levels of RPR and anti-Treponema IgG. The cutaneous biopsy revealed a non specific histological pattern, while the immunohistochemical evaluation with anti-spirochetal antibodies was mandatory for the diagnosis of recent syphilis, showing clusters of rod-shaped elements, some of which with spiral form, focally present at the epidermis and adnexal structures. CONCLUSIONS: Nowadays, syphilis may present with atypical clinical and serological features. Physicians should be aware of these possible alterations and consider syphilis even in case of uncommon clinical aspect and unclear serological tests. Cutaneous biopsy and immunohistochemical exam may be mandatory for the diagnosis.


Assuntos
Sífilis/diagnóstico , Treponema pallidum/isolamento & purificação , Anticorpos Antibacterianos/sangue , Biópsia , Infecções por HIV/complicações , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Recidiva , Minorias Sexuais e de Gênero , Sífilis/patologia , Sorodiagnóstico da Sífilis , Treponema pallidum/imunologia
3.
Pan Afr Med J ; 38: 248, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34104296

RESUMO

Yellow fever (YF) is a viral haemorrhagic fever caused by yellow fever virus transmitted by Aedes mosquitoes. Since 2013, in Chad, four cases of yellow fever have been detected and confirmed as part of the national fever surveillance program. We here report the last clinical case confirmed in the health district of Lai. The patient was a 57-year-old man with no significant medical and surgical history and unknown immunisation status. He consulted on April 21st, 2020 for fever, moderate to low abundance jaundice and epistaxis (nosebleed) and painful hepatomegaly. Paraclinical examinations, such as RT-PCR, objectified yellow fever virus in post-mortem tissue sample. Thus, confirmed yellow fever cases in this district, the low level of vaccination coverage, the circulation of the virus and the presence of vector in the country should warn of a real threat of reemergence of yellow fever in Chad.


Assuntos
Febre Amarela/diagnóstico , Vírus da Febre Amarela/isolamento & purificação , Aedes/virologia , Animais , Chade , Humanos , Masculino , Pessoa de Meia-Idade , Mosquitos Vetores/virologia , Recidiva , Febre Amarela/transmissão , Febre Amarela/virologia , Vacina contra Febre Amarela/administração & dosagem
4.
Georgian Med News ; (313): 26-33, 2021 Apr.
Artigo em Russo | MEDLINE | ID: mdl-34103425

RESUMO

The aim of the study is to substantiate the surgical treatment tactics of recurrence varicose veins after endovenous interventions. Early and long-term results of the treatment, quality of life of patients with recurrence of varicose veins were studied. Among the admitted patients, there were 55 (65.5%) women and 29 (34.5%) men, the age of patients varied from 19 to 76 years. Of these, 9 patients underwent crossectomy, endovenous laser coagulation - 22, various stripping options - 4, echosclerotherapy - 20, intraoperative catheter sclerobliteration - 1, ligation of perforating veins - 28 patients. The choice of the treatment method depends on the data of duplex angioscanning, the source of recurrence, the diameter and length of the varicose veins. In the early postoperative period 18 (22.6%) patients had complications and side effects. Most often hyperpigmentation and neurological disorders developed, which were observed in 8 (9.5%) and 7 (8.3%) cases. 2 (2.4%) patients had a slightly painful dense cord after endovenous laser coagulation. 1 (1.2%) patient had a lymphocele in the inguinal incision area. This complication was eliminated by use of the puncture treatment method. Long-term results in terms of 1 to 3 years were studied in 82 (97.6%) patients. In the long-term period, 1 (1.2%) patient noted the varicose veins recurrence due to neovasculogenesis in the groin. The patient underwent micro-foam echosclerotherapy. Patient`s quality of life was studied by using the CIVIQ2 questionnaire before and 1 year after treatment. It was found that 4 main indicators of the quality of life in the long-term period improved by 35.6-48.8% of the preoperative values. At the same time, the most significant positive dynamics of psychological (48.8%) and pain (47.1%) factors was observed. The results justify the need for a differentiated approach, taking into account the individual characteristics of the disease, as well as the expediency of using minimally invasive techniques in patients with varicose veins recurrence.


Assuntos
Ablação por Cateter , Terapia a Laser , Varizes , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Recidiva , Veia Safena/cirurgia , Escleroterapia , Resultado do Tratamento , Varizes/cirurgia , Adulto Jovem
5.
Georgian Med News ; (313): 84-88, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34103436

RESUMO

Long-term outcomes of glucocorticosteroid therapy in pulmonary sarcoidosis patients testify for high rate of relapses, which nowadays are the most acute problem in providing care to these patients. Aim - to study clinical factors, associated with pulmonary sarcoidosis relapse. 108 patients with newly diagnosed pulmonary sarcoidosis were examined (stage II - 102 patients, stage III - 6 patients). There were 48 male and 60 female, age from 24 to 64 years. The diagnosis of sarcoidosis was verified by high-resolution computed tomography (CT). All patients received GCS therapy with methylprednisolone 0,4 mg/kg for 4 weeks with subsequent dose tapering down to 0,1 mg/kg by the end of 6th month. Treatment was continued until clinical cure. Upon discontinuation of therapy the patients were followed for 2 years using CT-control in 6, 12 and 24 months. The relapse of sarcoidosis was registered in 56 patients (group 1); no relapse - in 52 patients (group 2). The rate of relapses was assessed in association with 10 clinical factors. Significance of the differences between qualitative indices was calculated as (M ± m) and Student's t value was calculated. Pearson's chi-squared test and Fisher's exact test were used to analyze the rate of relapses in association with studied factors. Clinical phenotype model of the patient with relapsing pulmonary sarcoidosis was created. It updated the known literature data and confirmed previously demonstrated role of GCS-therapy as the risk factor for sarcoidosis relapses. The following factors correlated with higher rate of relapses: 1) use of GCS therapy; 2) slow developing clinical symptoms; 3) extrapulmonary lesions; 4) bronchoconstriction; 5) concomitant diseases. Clinical phenotype model of patients with relapsing pulmonary sarcoidosis should be complemented by radiological, immunological, biochemistry factors, associated with the risk of relapse, which requires further research.


Assuntos
Sarcoidose Pulmonar , Sarcoidose , Adulto , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Fatores de Risco , Sarcoidose Pulmonar/diagnóstico por imagem , Sarcoidose Pulmonar/tratamento farmacológico , Adulto Jovem
6.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 29(3): 661-668, 2021 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-34105454

RESUMO

OBJECTIVE: To analyze the efficacy of CCLG-ALL-2008 protocol and the related factors of treatment failure in children with acute lymphoblastic leukemia (ALL). METHODS: The clinical data of 400 children newly-diagnosed ALL in Children's Hospital of Soochow University from March 1, 2008 to December 31, 2012 was retrospectively analyzed. All the children accepted CCLG-ALL-2008 protocol, and were followed-up until October 2019. The dates of relapse, death and causes of death were recorded. Treatment failure was defined as relapse, non-relapse death, and secondary tumor. RESULTS: Following-up for 10 years, there were 152 cases relapse or non-relapse death, the treatment failure rate was 38%, including 122 relapse (80.3%), 30 non-relapse deaths (19.7%) which included 7 cases (4 cases died of infection and 3 cases died of bleeding) died of treatment (23.3% of non-relapse deaths), 8 cases died of minimal residual disease (MRD) continuous positive (26.7% of non-relapse deaths) and 15 cases died of financial burden (50% of non-relapse deaths). According to the relapse stage, 37 cases (30%) in very early stage, 38 cases (31%) in early stage, and 47 cases (39%) in late stage, while according to the relapse site, 107 cases relapsed in bone marrow, 3 cases in testis, 3 cases in central nervous system (CNS), 5 cases in bone marrow plus testis and 4 cases in bone marrow plus CNS. Bone marrow relapse was the main cause of death in 89 cases, followed by nervous system. Initially diagnosed WBC count (≥50×109/L), T-cell immunophenotype, and MRD-positive at week 12 were the independent risk prognostic factors for relapse in children with ALL, while age (≥10 years), initially diagnosed WBC count (≥50×109/L), M3 bone marrow on day 15, and MRD-positive at week 12 were the independent risk factors due to treatment failure. No secondary tumors were found during the follow-up for 10 years. CONCLUSION: Relapse is the main cause of treatment failure in children with ALL. The initially diagnosed WBC count, immunophenotype and MRD at week 12 were the independent prognostic factors for relapse of the patients. Financial burden accounts for a large proportion of non-relapse death.


Assuntos
Leucemia-Linfoma Linfoblástico de Células Precursoras , Protocolos de Quimioterapia Combinada Antineoplásica , Criança , Intervalo Livre de Doença , Humanos , Masculino , Neoplasia Residual , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Prognóstico , Recidiva , Estudos Retrospectivos , Falha de Tratamento , Resultado do Tratamento
7.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 29(3): 696-702, 2021 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-34105459

RESUMO

OBJECTIVE: To observe the clinical efficacy of allogeneic peripheral blood stem cell transplantation(allo-HSCT) on the treatment of adult acute leukemia patients, moreover, to establish and evaluate a Logistic model to predict the risk of relapse in adult acute leukemia patients after allo-HSCT. METHODS: The clinical data of 145 adult acute leukemia patients treated by peripheral blood stem cell transplantation in the First Affiliated Hospital of Xi'an Jiaotong University from January 2010 to December 2019 was enrolled and analyzed retrospectively. Complications and survival of patients were observed. The relationship between patients' age, diagnosis, leukocyte count at onset, risk stratification, time of diagnosis to transplantation, HCT-CI, minimal residual disease pre-transplantation, donor-recipient sex relationship, HLA match degree, prophylaxis of graft versus host disease(GVHD), donor age, number of transfused mononuclear cells, CD34 positive cells, engraftment time, acute and chronic GVHD, CMV, EBV infection, and hemorrhagic cystitis and recurrence after transplantation were analyzed by logistic regression. Relapse prediction model was established and evaluated according to the results. RESULTS: Among 145 acute leukemia patients, 81 with acute myeloid leukemia, 64 with acute lymphocytic leukemia, 18 with EBV infection, 2 with post-transplant lymphoproliferative disorder(PTLD), 85 with CMV, 26 with hemorrhagic cystitis, 65 patients developed acute GVHD, 51 patients developed chronic GVHD and 45 patients relapsed. The overall survival (OS) rates in one and three years were 86.4% and 61.8%, and the progress-free survival (PFS) rates in one and three years were 67.5% and 62.4%, respectively. There were significant differences in OS and PFS between relapsed and non-relapsed patients, as well as AML and ALL patients. Univariate analysis revealed that patient's age, risk stratification, time to transplantation, HCT-CI index, ATG based GVHD prophylaxis, minimal residual disease pre-transplantation, GVHD prophylaxis, and acute and chronic GVHD were associated with the relapse of disease, multivariate logistic regression analysis showed that pre-transplantation minimal residual disease showed positively correlation with relapse of the disease, while chronic GVHD showed negatively correlation. CONCLUSION: The relapse rate of adult acute leukemia patients treated with allo-HSCT in our hospital is 31.0%, and OS of AML patients is better than ALL patients'. OS of relapsed patients is significantly lower than non-relapsed patients'. Pre-transplantation minimal residual disease is a risk factor of relapse. The risk of relapse is reduced in patients with chronic GVHD.


Assuntos
Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Leucemia Mieloide Aguda , Transplante de Células-Tronco de Sangue Periférico , Adulto , Humanos , Leucemia Mieloide Aguda/terapia , Recidiva , Estudos Retrospectivos , Condicionamento Pré-Transplante
8.
Viruses ; 13(5)2021 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-34064763

RESUMO

Infection with SARS-CoV-2 leading to COVID-19 induces hyperinflammatory and hypercoagulable states, resulting in arterial and venous thromboembolic events. Deep vein thrombosis (DVT) has been well reported in COVID-19 patients. While most DVTs occur in a lower extremity, involvement of the upper extremity is uncommon. In this report, we describe the first reported patient with an upper extremity DVT recurrence secondary to COVID-19 infection.


Assuntos
COVID-19/complicações , COVID-19/diagnóstico , Trombose Venosa/complicações , Trombose Venosa/diagnóstico , Idoso de 80 Anos ou mais , Transtornos da Coagulação Sanguínea/complicações , Humanos , Masculino , Recidiva Local de Neoplasia , Reação em Cadeia da Polimerase , RNA Viral , Recidiva , Fatores de Risco , Extremidade Superior/irrigação sanguínea , Trombose Venosa/terapia
9.
Medicina (Kaunas) ; 57(5)2021 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-34069436

RESUMO

Background and Objective: Patients with advanced non-small-cell lung cancer (NSCLC) harboring sensitizing epidermal growth factor receptor (EGFR) mutations show a good response to EGFR-tyrosine kinase inhibitors (EGFR-TKIs). The subsequent treatments influence the evaluability of the efficacy of front-line therapy on overall survival (OS). Consequently, we evaluated the associations of relapse-free survival (RFS) and post-progression survival (PPS) with OS in patients who exhibited postoperative relapse of EGFR-mutated NSCLC. Materials and Methods: We analyzed the data of 35 patients with EGFR-mutated NSCLC who underwent complete resection between January 2007 and June 2019. The correlations of RFS and PPS with OS were evaluated at the individual patient level. Results: Linear regression and Spearman's rank correlation analyses demonstrated that the PPS highly correlated with OS (r = 0.91, p < 0.05, R2 = 0.85), whereas the RFS weakly associated with OS (r = 0.36, p < 0.05, R2 = 0.25). Age and performance status at relapse were significantly associated with PPS. Conclusion: Overall, PPS was more strongly and significantly associated with OS than RFS. These results suggest that the OS of our cohort may be affected by treatments, besides postoperative relapse. However, larger-scale prospective studies are needed to confirm these results.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Receptores ErbB/genética , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/cirurgia , Mutação , Estadiamento de Neoplasias , Estudos Prospectivos , Inibidores de Proteínas Quinases/uso terapêutico , Recidiva , Taxa de Sobrevida , Resultado do Tratamento
10.
BMC Gastroenterol ; 21(1): 250, 2021 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-34092231

RESUMO

BACKGROUND: Few studies have reported whether a biopsy in emergency gastroscopy (EG) increased the risk of rebleeding in patients with Forrest I acute nonvariceal upper gastrointestinal bleeding (ANVUGIB) combined with suspected malignant gastric ulcer (SMGU). This study aims to conduct a multicenter retrospective cohort study using propensity score matching to verify whether a biopsy in EG increases the risk of rebleeding in patients diagnosed with Forrest I ANVUGIB combined with SMGU. METHODS: Using the data for propensity-matched patients, logistic regression models were fitted using rebleeding as the dependent variable. Survival time was defined as the length of time the patient experienced from visiting the emergency department to rebleeding. We used the Kaplan-Meier (KM) method to analyze the 30-day survival of the patients with and without a biopsy after matching, and the log-rank test was performed to examine the differences in survival. RESULTS: With the use of propensity score matching, 308 patients who underwent a biopsy in EG were matched with 308 patients who did not. In the five logistic regression models, there were no significant group differences in the risk of rebleeding in patients with Forrest I ANVUGIB combined with SMGU between the biopsy and no-biopsy groups. The probability of survival was not significantly different between the no-biopsy and biopsy groups. CONCLUSIONS: In this multicenter, retrospective propensity score matching cohort study, compared with patients without a biopsy, patients with a biopsy during EG had no increased risk of rebleeding, and there was no significant difference in the rate of rebleeding.


Assuntos
Úlcera Gástrica , Biópsia , Estudos de Coortes , Serviço Hospitalar de Emergência , Hemorragia Gastrointestinal/etiologia , Gastroscopia , Humanos , Recidiva , Estudos Retrospectivos , Úlcera Gástrica/complicações
11.
Bone Joint J ; 103-B(6): 1021-1030, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34058871

RESUMO

AIMS: The aim of this meta-analysis was to assess the prognosis after early functional rehabilitation or traditional immobilization in patients who underwent operative or nonoperative treatment for rupture of the Achilles tendon. METHODS: PubMed, Embase, Web of Science, and Cochrane Library were searched for randomized controlled trials (RCTs) from their inception to 3 June 2020, using keywords related to rupture of the Achilles tendon and rehabilitation. Data extraction was undertaken by independent reviewers and subgroup analyses were performed based on the form of treatment. Risk ratios (RRs) and weighted mean differences (WMDs) (with 95% confidence intervals (CIs)) were used as summary association measures. RESULTS: We included 19 trials with a total of 1,758 patients. There was no difference between the re-rupture rate (RR 0.84 (95% CI 0.56 to 1.28); p = 0.423), time to return to work (WMD -1.29 (95% CI -2.63 to 0.05); p = 0.060), and sporting activity (WMD -1.50 (95% CI -4.36 to 1.37); p = 0.306) between the early functional rehabilitation and the traditional immobilization treatment strategies. Early rehabilitation up to 12 weeks yielded significantly better Achilles tendon Total Rupture Scores ((ATRS) WMD 5.11 (95% CI 2.10 to 8.12); p < 0.001). Patients who underwent functional rehabilitation had significantly lower limb symmetry index of heel-rise work ((HRW) WMD -4.19 (95% CI -8.20 to 0.17); p = 0.041) at one year. CONCLUSION: Early functional rehabilitation is safe and provides better early function and the same functional outcome in the longer term. Cite this article: Bone Joint J 2021;103-B(6):1021-1030.


Assuntos
Tendão do Calcâneo/lesões , Imobilização , Modalidades de Fisioterapia , Traumatismos dos Tendões/reabilitação , Traumatismos em Atletas/reabilitação , Humanos , Prognóstico , Recuperação de Função Fisiológica , Recidiva
12.
Isr Med Assoc J ; 23(5): 297-301, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34024046

RESUMO

BACKGROUND: Management of acquired laryngotracheal stenosis (LTS) is challenging and often requires recurrent procedures. OBJECTIVES: To compare the efficacy and safety of balloon dilatation (BD) versus rigid dilatation (RD) in the treatment of LTS. METHODS: A retrospective study of patients undergoing endoscopic intervention for LTS was performed. RESULTS: The study included 69 balloon (BD) and 48 rigid dilations (RD). Most cases were grade 3 Cotton-Meyer stenosis. Mean time interval to recurrence after BD and RD were 27.9 and 19.6 weeks, respectively. Remission of over 8 weeks was achieved in 71% of BD compared to 31.2% of RD (P < 0.05). In the BD group, dilatation of subglottic stenosis showed higher rates of remission of over 8 weeks compared to upper and mid-tracheal stenosis (92% vs. 62% and 20%, respectively, P < 0.05). Complications were encountered in 4.2% of RD and 2.9% of BD. CONCLUSIONS: BD and RD are effective and safe procedures. Overall, BD achieved slightly better long-term results compared to RD.


Assuntos
Dilatação/métodos , Endoscopia/métodos , Laringoestenose/terapia , Estenose Traqueal/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Dilatação/efeitos adversos , Desenho de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Indução de Remissão , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
13.
J Am Vet Med Assoc ; 258(11): 1229-1235, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33978438

RESUMO

OBJECTIVE: To describe surgical management and associated outcomes for dogs with primary spontaneous pneumothorax. ANIMALS: 110 client-owned dogs with primary spontaneous pneumothorax that underwent surgical management. PROCEDURES: Medical records at 7 veterinary teaching hospitals were reviewed. Data collected included signalment, history, clinical signs, radiographic and CT findings, surgical methods, intraoperative and postoperative complications, outcomes, and histopathologic findings. Follow-up information was obtained by contacting the referring veterinarian or owner. RESULTS: 110 dogs were included, with a median follow-up time of 508 days (range, 3 to 2,377 days). Ninety-nine (90%) dogs underwent median sternotomy, 9 (8%) underwent intercostal thoracotomy, and 2 (2%) underwent thoracoscopy as the sole intervention. Bullous lesions were most commonly found in the left cranial lung lobe (51/156 [33%] lesions) and right cranial lung lobe (37/156 [24%] lesions). Of the 100 dogs followed up for > 30 days, 13 (13%) had a recurrence of pneumothorax, with median time between surgery and recurrence of 9 days. Recurrence was significantly more likely to occur ≤ 30 days after surgery, compared with > 30 days after surgery. Recurrence > 30 days after surgery was rare (3 [3%]). No risk factors for recurrence were identified. CONCLUSIONS AND CLINICAL RELEVANCE: Lung lobectomy via median sternotomy resulted in resolution of pneumothorax in most dogs with primary spontaneous pneumothorax. Recurrence of pneumothorax was most common in the immediate postoperative period, which may have reflected failure to identify lesions during the initial thoracic exploration, rather than development of additional bullae.


Assuntos
Doenças do Cão , Pneumopatias , Pneumotórax , Animais , Doenças do Cão/cirurgia , Cães , Pneumopatias/cirurgia , Pneumopatias/veterinária , Pneumotórax/cirurgia , Pneumotórax/veterinária , Recidiva , Estudos Retrospectivos , Toracotomia/veterinária
14.
Medicine (Baltimore) ; 100(21): e26036, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34032726

RESUMO

BACKGROUND: As a gynecological disease, endometriosis (EM) seriously endangers the health of women at the age of childbearing and is closely related to long noncoding RNAs (lncRNAs). Current studies have discovered that there are differential expressions of many kinds of lncRNAs in EM. However, whether lncRNAs can be applied as a new marker for the prediction of the recurrence of EM is still controversial. In this study, meta-analysis and bioinformatics analysis were carried out to explore the value of lncRNAs as a predictor of the recurrence of EM and to analyze its biological role. METHODS: PubMed, Embase, and Web of Science databases were searched through computer and the articles published from the self-built database to April 2021 were collected. According to the inclusion and exclusion criteria, the literature was screened, and the quality of the inclusion study was evaluated. Stata 16.0 software was used for meta-analysis. The co-expression genes related to lncRNAs were screened by online tool Co-LncRNA. Then David for Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis were conducted. A competitive endogenous RNA network that may exist in lncRNAs through Starbase was built. RESULTS: The results of this meta-analysis would be submitted to peer-reviewed journals for publication. CONCLUSION: This meta-analysis could provide high-quality evidence support for lncRNAs, so as to predict the recurrence of EM. At the same time, we use bioinformatics technology to predict and analyze its biological effects, which provides a theoretical basis for further experimental verification. ETHICS AND DISSEMINATION: The private information from individuals will not be published. This systematic review also should not damage participants' rights. Ethical approval is not available. The results may be published in a peer-reviewed journal or disseminated in relevant conferences. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/MF3QJ.


Assuntos
Endometriose/diagnóstico , Redes Reguladoras de Genes , RNA Longo não Codificante/análise , Biomarcadores/análise , Biomarcadores/metabolismo , Biologia Computacional , Endometriose/genética , Endometriose/patologia , Endometriose/cirurgia , Endométrio/patologia , Endométrio/cirurgia , Feminino , Humanos , Metanálise como Assunto , RNA Longo não Codificante/metabolismo , Recidiva
15.
Medicine (Baltimore) ; 100(21): e26091, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34032746

RESUMO

INTRODUCTION: This work reports a patient with recurrent renal calculi subjected to three surgeries in half a year to be in the same position, and the high-throughput sequencing data showed different species in the renal pus and urine samples, which suggested that partial renal infection or stone formation can be judged by the bacteria in urine. PATIENT CONCERNS: The female patient aged 43 years was referred to the authors' department on April 13, 2020, due to left waist pain and fever for 3 days. DIAGNOSIS: Kidney stones and hydronephrosis were determined by a urinary system computed tomography scan. INTERVENTIONS: On April 20, 2020 and June 15, 2020, the patient was successfully treated with left percutaneous nephrolithotomy twice under general anesthesia. An investigation on the health and eating habits of the patient within 6 months was completed at the last admission. The components of the second renal calculus sample were analyzed with an infrared spectrum analyzer. The third renal stone (renal pus, triplicates) was subjected to microbial metagenome sequencing, and urine samples before and after surgery were subjected to 16S RNA sequencing by SEQHEALTH (Wuhan, China). OUTCOMES: After percutaneous nephrolithotomy, the left kidney stones were basically cleared, stone analysis revealed that the main components were calcium oxalate monohydrate, silica, and a small amount of calcium oxalate dehydrate. Although the urine samples exhibited differences, the renal pus and urine sample shared a single species. CONCLUSION: It is not clear that the prospects of partial renal infection or stone formation can be judged by the bacteria in urine.


Assuntos
Infecções por Helicobacter/diagnóstico , Hidronefrose/diagnóstico , Cálculos Renais/diagnóstico , Nefrolitotomia Percutânea/efeitos adversos , Infecções Urinárias/diagnóstico , Adulto , DNA Bacteriano/isolamento & purificação , Feminino , Infecções por Helicobacter/complicações , Infecções por Helicobacter/microbiologia , Infecções por Helicobacter/cirurgia , Helicobacter pylori , Humanos , Hidronefrose/microbiologia , Hidronefrose/cirurgia , Cálculos Renais/microbiologia , Cálculos Renais/cirurgia , Metagenoma/genética , RNA Ribossômico 16S/genética , Recidiva , Reoperação , Infecções Urinárias/complicações , Infecções Urinárias/microbiologia , Infecções Urinárias/cirurgia
16.
Medicine (Baltimore) ; 100(21): e26148, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34032769

RESUMO

RATIONALE: Redo surgeries after mitral valve repair are technically demanding. Procedures applying the NeoChord device (NeoChord Inc, St. Louis Park, MN) have proven to be safe and feasible in selected patients requiring mitral valve repair due to a leaflet prolapse or flail. However, its use for redo procedures after conventional surgical repair has not been well established yet. PATIENT CONCERNS: We report the case of a 57-year-old man who presented with dyspnea upon exertion. The patient had undergone a minimally invasive surgical mitral valve repair because of a flail leaflet of the segments segment 2 of the posterior mitral valve leaflet (P2)/segment 3 of the posterior mitral valve leaflet (P3) 4 years before. DIAGNOSES: Transesophageal echocardiography identified a relapse of severe mitral valve regurgitation. The recurring regurgitant jet was caused by a flail leaflet due to newly ruptured native chords. INTERVENTIONS: After discussion in an interdisciplinary heart team, we performed a minimally invasive off-pump redo procedure applying the NeoChord device under three-dimensional transesophageal echocardiographic guidance. OUTCOMES: The echocardiographic result with only trivial residual mitral regurgitation as well as the further clinical course of the patient were favorable. LESSONS: As redo surgery after minimally invasive mitral valve repair is challenging, the NeoChord device represents a novel treatment option that does not require cardiopulmonary bypass.


Assuntos
Cordas Tendinosas/cirurgia , Implante de Prótese de Valva Cardíaca/métodos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Insuficiência da Valva Mitral/cirurgia , Ecocardiografia Transesofagiana , Implante de Prótese de Valva Cardíaca/instrumentação , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/instrumentação , Insuficiência da Valva Mitral/diagnóstico por imagem , Recidiva , Reoperação
17.
BMC Neurol ; 21(1): 183, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33933026

RESUMO

BACKGROUND: Choosing a safe disease modifying therapy during the COVID-19 pandemic is challenging. This case series study was conducted to determine the incidence rate and the course of Covid-19 infection in MS/NMOSD patients treated with Rituximab. METHODS: In this study, we designed a web-based questionnaire. Baseline information such as patient- reported walking disability, total number of Rituximab infusions received, delayed injections, occurrence of any relapse, and the use of corticosteroids during the pandemic were collected. Also, information regarding the Covid-19 pandemic such as adherence to self-isolation, any recent exposure to an infected individual and the presence of suggestive symptoms were collected. In case of positive test results, patients were grouped into 2 categories; mild to moderate and seriously ill and outcomes were evaluated as favorable (improved/ discharged) and unfavorable (expired). RESULTS: Two hundred fifty-eight patients with Multiple Sclerosis were enrolled in this study, 9 of the subjects (3.4%) were confirmed positive for Covid-19, five of which required hospitalizations (55.5%), two patients required ICU admission (22.2%) and 2 two patients died (22.2%). None of these patients ever mentioned using corticosteroids during the pandemic. In comparison to MS patients who were not receiving disease modifying therapy (DMT), our study indicated a higher incidence of Covid-19 infection, higher ratio of serious illness and a higher fatality ratio. CONCLUSIONS: Rituximab seems not to be safe enough during the pandemic.


Assuntos
/epidemiologia , Fatores Imunológicos/efeitos adversos , Esclerose Múltipla/epidemiologia , Rituximab/efeitos adversos , Adolescente , Adulto , Feminino , Humanos , Fatores Imunológicos/administração & dosagem , Masculino , Recidiva , Rituximab/administração & dosagem , Adulto Jovem
18.
Urologiia ; (2): 51-56, 2021 May.
Artigo em Russo | MEDLINE | ID: mdl-33960157

RESUMO

AIM: to evaluate the efficiency of the dietary supplement NefroBest in women with chronic cystitis. MATERIALS AND METHODS: On the basis of the Department of Urology and Nephrology of the Altai State Medical University and the urological department of the NUZ CH "RJD Medicine", Barnaul, from September 2019 to August 2020 a total of 40 women with chronic cystitis were treaeted. Depending on the type of treatment, all women were divided into the main and control groups, each of 20 people. In the main group, patients received standard therapy and dietary supplements NefroBest. In the control group, patients were prescribed only to standard therapy. RESULTS: The results were evaluated one and two months after the start of therapy. In the main group a more rapid resolution of symptoms and laboratory abnormalities were seen, as well as an improvement of the endoscopic picture and urodynamic parameters. CONCLUSION: The complex of biologically active substances in the dietary supplement NefroBest has an antimicrobial, anti-inflammatory and antispasmodic effect, and reduces the risk of recurrence of chronic cystitis. Thus, the dietary supplement NefroBest can be recommended as a component of the complex therapy of recurrences of chronic cystitis, as well as a prophylactic treatment during relapse-free period.


Assuntos
Anti-Infecciosos , Cistite , Antibacterianos/uso terapêutico , Anti-Infecciosos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Cistite/tratamento farmacológico , Cistite/prevenção & controle , Feminino , Humanos , Recidiva
19.
Urologiia ; (2): 74-77, 2021 May.
Artigo em Russo | MEDLINE | ID: mdl-33960161

RESUMO

OBJECTIVE: Our study aims to improve hypospadias in children by successfully correcting ventral penile curvature. MATERIALS AND METHODS: From 2014 to 2018, 424 patients with ventral penile curvature of 15-60 degrees were treated. All patients were divided into 3 groups depending on the form of hypospadias: Group I consists of 303 patients with subcoronal and midshaft hypospadias; Group II - 48 patients with midshaft hypospadias who earlier underwent urethroplasty; Group III - 73 patients with chordee without hypospadias. To correct ventral curvature in all cases - STAGE technique was applied. RESULTS: No recurrence of penile curvature was noted in any of the three groups in the early and late post-operative follow-up of up to 1 year. CONCLUSIONS: Ventral curvature penile correction is important for the future sexual life of the patient. Attention should be paid to this stage of the hypospadias repair. STAGE technique allows to correct ventral curvature of 15 - 60 degrees with minimal number of complications.


Assuntos
Hipospadia , Procedimentos Cirúrgicos Reconstrutivos , Criança , Humanos , Hipospadia/cirurgia , Lactente , Masculino , Pênis/cirurgia , Recidiva , Uretra/cirurgia , Procedimentos Cirúrgicos Urológicos Masculinos
20.
Medicine (Baltimore) ; 100(18): e25775, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33950969

RESUMO

RATIONALE: The relationship between spontaneous coronary artery dissection (SCAD) and takotsubo syndrome (TTS) remains unclear. Coexistence of SCAD and TTS has been reported in the literature. However, the relationship between these two diseases has not yet been elucidated. PATIENT CONCERNS: A 36-year-old breastfeeding woman was brought to our hospital 52 days after cesarean section because of discomfort in her left arm and convulsions. DIAGNOSES: She was diagnosed of acute myocardial infarction (AMI). The convulsions were attributed to lethal arrhythmia. INTERVENTIONS: An immediate coronary angiography revealed that her left anterior descending artery (LAD) was Type 2a SCAD, but with no flow limitation. In addition, a 12-lead electrocardiogram (ECG) revealed improvement in ST-elevation. We chose the conservative treatment according to the patient's needs. OUTCOMES: Conservative treatment was unsuccessful. She developed another acute myocardial infarction requiring another percutaneous coronary intervention (PCI) during hospitalization. From the course of hospitalization, we suspected the coexistence of SCAD and TTS. LESSONS: When we treat patients with SCAD, we should consider the possibility of coexistence of TTS and confirm left ventricular wall motion. Patients with SCAD may require invasive treatment, hence, should be monitored for a while. An urgent strategy for managing patients with SCAD who require PCI should be established.


Assuntos
Tratamento Conservador , Anomalias dos Vasos Coronários/diagnóstico , Intervenção Coronária Percutânea , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Cardiomiopatia de Takotsubo/diagnóstico , Doenças Vasculares/congênito , Adulto , Aleitamento Materno , Angiografia Coronária , Anomalias dos Vasos Coronários/complicações , Anomalias dos Vasos Coronários/terapia , Vasos Coronários/diagnóstico por imagem , Vasos Coronários/cirurgia , Ecocardiografia , Eletrocardiografia , Feminino , Ventrículos do Coração/diagnóstico por imagem , Humanos , Inibidores da Agregação Plaquetária/uso terapêutico , Recidiva , Infarto do Miocárdio com Supradesnível do Segmento ST/etiologia , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Prevenção Secundária/métodos , Cardiomiopatia de Takotsubo/complicações , Resultado do Tratamento , Doenças Vasculares/complicações , Doenças Vasculares/diagnóstico , Doenças Vasculares/terapia
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